Use of antiretroviral treatment among people living with HIV in Australia between 1997 and 2012

ABSTRACT

Current international targets aim for 90% of people diagnosed with HIV to be on antiretroviral treatment (ART). This paper aims to identify sociodemographic and attitudinal factors associated with ART non-use over time in three samples of Australian people living with HIV (PLHIV). Data for this paper were derived from an Australian cross-sectional survey of PLHIV that was repeated at three different time points: 1997, 2003, and 2012. There were approximately 1000 respondents to each survey (n = 3042 in total). The survey included approximately 250 items related broadly to health and well-being, ART use, and attitudes towards ART use. Univariate and multivariate logistic regression analyses were used. While the proportion of participants using ART increased between 1997 and 2012 (78.8–87.6%, p < .001), there was a decrease between 1997 and 2003 to 70.6% (p < .001). Factors linked to ART non-use remained steady over those 15 years. In all cohorts, people less likely to be using ART were younger and had a more recent diagnosis of HIV. In 2003 and 2012, people in full-time employment were less likely to be using ART, while those whose main source of income was a pension or social security were more likely to be using ART. Multivariate models showed that, at each time point, a belief in the health benefits of delayed ART uptake was associated with non-use. These findings suggest that there may be barriers to ART uptake that have persisted over time despite changes to clinical guidelines that now encourage early uptake.

KEYWORDS:

• Antiretroviral therapy
• antiretroviral therapy non-use
• Australia
• antiretroviral therapy delayed uptake

Acknowledgements

This project is supported by the following peak HIV organisations and their members: the National Association of People with HIV Australia (NAPWHA), the Australian Federation of AIDS Organisations (AFAO), and the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM). Researchers involved in HIV Futures include Michael Bartos, Richard de Visser, Douglas Ezzy, Jeffrey Grierson, Rachel Koelmeyer, Karalyn McDonald, Marian Pitts, Doreen Rosenthal and Rachel Thorpe.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCiD

J. Power http://orcid.org/0000-0002-6566-3214

J. Lucke http://orcid.org/0000-0002-2885-5292

Additional information

Funding

This project is funded by the Australian Department of Health.